CASE REPORT

http://dx.doi.org/10.4046/trd.2013.75.5.214 ISSN: 1738-3536(Print)/2005-6184(Online) • Tuberc Respir Dis 2013;75:214-217

Spontaneous Regression of Non-Small Cell Lung Cancer in a Patient with Idiopathic Pulmonary Fibrosis: A Case Report

Eu Dong Hwang, M.D.1, Young Jae Kim, M.D.1, Ah Young Leem, M.D.1, Ah-Young Ji, M.D.1, Younjeong Choi, M.D.1, Ji Ye Jung, M.D.1, Se Kyu Kim, M.D., Ph.D.1, Joon Chang, M.D., Ph.D.1, Ji Hye Park, M.D.2 and Seon Cheol Park, M.D.3 1

Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, 2Department of Pathology, Yonsei University College of Medicine, Seoul, 3Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Treatment of lung cancer in patients with idiopathic pulmonary fibrosis (IPF) is difficult because the mortality rate after surgery or chemotherapy is high for these patients. Spontaneous regression of cancer is rare, especially in lung cancer. A 62-year-old man, previously diagnosed with IPF, presented with stage IIIC (T2N3M0) non-small cell lung cancer. About 4 months later, spontaneous regression of the primary tumor was observed without treatment. To the best of our knowledge, this is the first report of spontaneous regression of lung cancer in a patient with IPF. Keywords: Lung Neoplasms; Fibrosis; Neoplasm Regression, Spontaneous

Introduction Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of lung cancer. Atypical or dysplastic epithelial changes in pulmonary fibrosis can be involved in lung cancer carcinogenesis1. Large, population-based cohort studies report an increased incidence of lung cancer in IPF patients compared to normal subjects2,3. Spontaneous regression (SR) Address for correspondence: Seon Cheol Park, M.D. Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan-ro 200, Ilsandong-gu, Goyang 410-719, Korea Phone: 82-31-900-0271, Fax: 82-31-900-0343 E-mail: [email protected] Received: May 28, 2013 Revised: Jul. 11, 2013 Accepted: Aug. 22, 2013 cc

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Copyright © 2013 The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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of cancer, defined as a complete or partial disappearance of malignant disease without treatment, is rare4. SR of lung cancer is extremely rare in general, and especially in patients with non-small cell lung cancer (NSCLC) supervening on IPF. We present a rare case of NSCLC in a patient with IPF whose tumor spontaneously regressed without treatment.

Case Report A 62-year-old man complaining of dyspnea was referred to our hospital in November 2011. He had a 70 pack-year history of smoking, and a history of diabetes mellitus. Chest computed tomography (CT) revealed a diffuse subpleural reticular pattern and honeycombing in both lungs without mass-like lesions, suggesting IPF (Figure 1). A follow-up chest CT was performed in May 2012. The image revealed a newly developed, 3.2×2.3 cm, irregular mass widely abutting pleura in the left upper lobe (Figure 2A). The CT also revealed multiple enlarged lymph nodes in the paratracheal, subcarinal, prevascular, subaortic, hilar and supraclavicular areas (Figure 2B). Similarly, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) showed multiple

Spontaneous regression of non-small cell lung cancer

lymph node enlargements with increased FDG uptake in the hilar, subcarinal, paratracheal, subaortic, prevascular and supraclavicular areas (Figure 3). Carcinoembryonic antigen was 2.41 ng/mL (normal range,

Spontaneous regression of non-small cell lung cancer in a patient with idiopathic pulmonary fibrosis: a case report.

Treatment of lung cancer in patients with idiopathic pulmonary fibrosis (IPF) is difficult because the mortality rate after surgery or chemotherapy is...
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